Tuesday Talk Show's Podcast

QUESTION: " I have angina upon exertion.  I have been on the Esselstyn diet with about 90-95% compliance. My numbers are better, but my symptoms have not improved.  I have been told to wait 5 years.  I don't want to put my life on hold any longer.  What are your thoughts?"

BASIC ESSELSTYN DIET: Dr. Esselstyn's diet revolves around swearing off much of the typical Western diet. It means halting consumption of all meat, eggs, dairy products, nuts and processed foods. No meat. No organic chicken, no wild fish, no cold cuts. One more thing: You can't even consume oils -- not even olive oil. 

Fruit, vegetables (except avocados, which are too fatty), whole grains and legumes. Those are the core of what one can eat. Dr. Esselstyn's argument is that living by the standards of this diet will prevent the onset of heart disease, among other health problems.

QUESTION:  If I am a hyper-absorber of plant sterols, am I sensitive to fats in general?  Should I reduce my omega 3 intake?

GENERAL BACKGROUND: Plant sterols are naturally occurring substances found in plants. They are present in small quantities in many fruits, vegetables, vegetable oils, nuts, seeds, cereals and legumes.

Research has shown that plant sterols included with a heart healthy eating plan may reduce your risk for heart disease. The sterols work by blocking the absorption of cholesterol in the small intestine. This lowers the low density cholesterol known as the 'bad' cholesterol (LDL ) by 6-15%, without lowering the good cholesterol known as the high density cholesterol ( HDL).

QUESTION: "My Lp-PLA2  bloodwork shows me at risk for arterial inflammation.  I understand there is a new drug being tested to reduce Lp-PLA2.  Should I take it as soon as it is available?"

GENERAL BACKGROUND:

Advanced tests measure blood levels of an enzyme called lipoprotein phospholipase A2 (Lp-PLA2). The Lp-PLA2 enzyme unleashes a chain of harmful events culminating in endothelial dysfunction, which is a pathological abnormality in the blood vessel wall that sets the stage for atherosclerosis, plaque accumulation, and rupture.

An elevated level of Lp-PLA2 may signal that an arterial plaque is susceptible to rupture, which could cause a clot to break loose, precipitating a heart attack or stroke.